Comparison of considerations for intensification strategies for relapsed follicular lymphoma—CAR-T vs autologous transplant
. | Autologous transplant . | CAR-T . |
---|---|---|
Requires chemosensitive disease | Yes | No |
Potential benefit limited to early in relapsed course | Yes | No* |
Short-term toxicities | Mucositis, infection, sepsis, pneumonitis, poor engraftment | CRS, ICANS, cytopenia, infection |
Long-term toxicities | Therapy-related myeloid malignancies | B-cell aplasia, hypogammaglobulinemia, cytopenia* |
Other considerations | Need for adequate marrow reserve for stem cell collection, eligibility limited to fit patients | Need for adequate lymphocyte count, wait time for and requirement of successful T-cell manufacturing, likely lower fitness requirement than autologous transplant |
. | Autologous transplant . | CAR-T . |
---|---|---|
Requires chemosensitive disease | Yes | No |
Potential benefit limited to early in relapsed course | Yes | No* |
Short-term toxicities | Mucositis, infection, sepsis, pneumonitis, poor engraftment | CRS, ICANS, cytopenia, infection |
Long-term toxicities | Therapy-related myeloid malignancies | B-cell aplasia, hypogammaglobulinemia, cytopenia* |
Other considerations | Need for adequate marrow reserve for stem cell collection, eligibility limited to fit patients | Need for adequate lymphocyte count, wait time for and requirement of successful T-cell manufacturing, likely lower fitness requirement than autologous transplant |
Long-term follow-up evaluating both risk and benefit in large cohorts of patients with FL receiving CAR-T is limited.
ICANS, immune effector cell-associated neurotoxicity syndrome.